Children's rashes and spots in pictures - Hand, foot and mouth

Chickenpox, measles, meningitis or heat rash? Our real-life photos and expert advice will help you identify the most common toddler rashes and spots and guide you on what to do next

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  • Chickenpox

    What does a chickenpox rash look like?

    Crops of red spots, which turn into small, fluid-filled, itchy blisters that break and then scab over.

    Where?

    Anywhere on the body. Several crops of spots may develop over a few days.

    Who gets it?

    Anyone who has not had chickenpox.

    What can you do?

    Normally no treatment is necessary, but your child is infectious from two days before the rash emerges until all the spots have crusted over.

    Encourage your child not to scratch to avoid scarring, and soothe itchiness with calamine lotion.

    Mum’s story - “Luckily he was too young to pick at his chickenpox”

    “Jude was 11 months when he caught chickenpox. He came up in small blisters all around the nappy area, which crusted over after three days. That’s when they really itched, but luckily he was too young to pick the spots. The scabs then gradually dropped off. It was all over quite quickly really.”

    Gemma, mum to Zoe, 7, Freya, 5, and Jude, 3

  • Meningitis rash

    What does meningitis look like?

    The meningitis rash occurs when septicaemia - blood poisoning - has set in. it is a non-fading rash, it won’t disappear under a glass tumbler when pressed. See here for the Glass Test. Meningitis alone rarely causes as rash. Meningitis UK says: “In addition to the other symptoms of meningitis, other symptoms to look out for in babies and toddlers are blotchy skin, quite pale or turning blue; tense or bulging soft spot; poor feeding; high-pitched crying/irritable,” but it adds that, “The classical signs and symptoms of meningitis may be absent in babies and toddlers.”

    Where?

    It can appear anywhere on the body and is due to the leaking of the capillaries which results in blood accumulating directly under the skin. See here for more on meningitis.

    Who gets it?

    Anyone at any age but, as Meningitis UK says: “Babies do not replace the temporary natural immunity they get from their mothers until school age and so are at greater risk.”

    What can you do?

    If you suspect meningitis, take your child to the hospital immediately.

  • Measles

    What does measles look like?

    Tiny white spots with a red outline (called Koplik’s spots) followed a few days later by a fine red rash that starts small and becomes blotchy. This rash proceeds initial cold-like symptoms, such as red eyes, sensitivity to light, a fever and greyish white spots in the mouth or throat.

    Where?

    Koplik’s spots develop in the mouth, on the cheeks. The rash typically starts behind the ears and then spreads to the body

    Who gets it?

    “Measles is not to common now because of immunisation,” says Adam Finn, Professor of Paediatrics at the University of Bristol. “But anyone who has not been properly vaccinated is potentially at risk.”

    It is most common in children aged between 1 and 4 years old.

    It is a type of virus called “paramyxovirus”. It can be contracted by an infected person’s salvia: so if they cough or sneeze near your child – and your child is not vaccinated – your child could breathe in tiny droplets and get the disease. It is so highly infectious that, if your child hasn’t been vaccinated and comes into contact with an infected person, your child has a 90% chance of contracting it.

    What can you do?

    See your GP immediately if you suspect measles. A salvia test can confirm it and the local Health Protection Unit will be informed. Your child should not return to school until the measles are under control. There is no specific treatment for measles – all you can do is make your child feel comfortable until it passes.

    The NHS recommends liquid baby paracetamol or ibuprofen to relieve their fever, aches and pains. They should also drink plenty of water to prevent dehydration and “damp cotton wool can be used to clean away any crustiness around the eyes. Use one piece of cotton wool per wipe for each eye,” says the NHS, and “gently clean the eye from inner to outer eyelid.”

  • Eczema

    What does eczema look like?

    A dry, red patch of skin that may be broken or cracked. The most common form in children is atopic eczema. “People with mild atopic eczema normally have only small areas of dry skin that are occasionally itchy. In more severe cases, atopic eczema can cause widespread dry skin, constant itching and oozing fluid,” says the NHS.

    Eczema suffers tend to get “flare-ups”, when their symptoms worsen. During a flare-up, sufferers get extremely red and itchy weeping, swollen skin. The skin can sometimes become infected.

    Where?

    It can occur anywhere on the body, but in infants you are most likely to see it on the face, arms and legs and in children on their hands, around their joints, such as around their elbows or the backs of their knees.

    Who gets it?

    It is thought to be an inherited condition and anyone can get it, but atopic eczema is the most common form in children.

    What can you do?

    If your child has atopic eczema, their condition may improve over time but the most common treatments include moisturizing treatments – emollients – that can be bought from your pharmacy. Topical corticosteroids may also be prescribed to reduce your child’s swelling.

    Although it may be difficult, it is important to discourage your child from scratching. You can keep their nails short to stop them. “Scratching can aggravate the skin, eventually causing it to thicken. Scratching your skin also increases the risk of your eczema becoming infected with bacteria,” says the NHS.

    Flare-ups of eczema are often caused by a trigger. Certain fabrics, for example, or heat or detergents may irritate your child’s eczema.

    While diet may play some part in causing a flare-up, you should not significantly alter your child’s diet without first talking to your GP. If your GP suspects your child is suffering from a food allergy, they will refer him to an allergy specialist.

  • Heat rash or prickly heat

    What does heat rash look like?

    Also known as miliaria or prickly heat, it appears as tiny little red bumps or blisters on the skin and it happens when your child gets too hot. They often sting or feel prickly.

    Where?

    Anywhere on the body, but often in places covered by clothing. “It can also occur in skin creases,” says Nina Goad from the British Association of Dermatologists.

    Who gets it?

    Anyone can get it. It happens when your child sweats more than usual during hot weather. But it’s possible to get it any time of the year, it just happens when your child overheats. The bumps form when the sweat glands get blocked and the sweat becomes trapped under their skin, causing the rash.

    What can you do?

    “Heat rash is a sign your child is too warm, so keep her cool and make sure she isn’t dehydrated,” says Nina. It usually goes away on its own, but ease symptoms with a cool bath and calamine lotion.

    If your child is prone to heat rash, there are a few things you can do to prevent them from getting it: dress them in loose, cotton clothing in the heat. Cotton is great when it’s warm as the fabric absorbs moisture, rather than trapping it like some synthetic fibres.

  • German measles (also known as rubella)

    What does rubella look like?

    As well as a raised temperature and conjunctivitis, a pink-red rash will appear. It will come up as slightly itchy spots, which may merge to form patches. This rash is often accompanied by swollen lymph nodes and cold-like symptoms.

    Where?

    It usually starts behind the ears and then spreads to the head, neck, trunk, legs and arms.

    Who gets it?

    It’s a respiratory disease and is fairly rare as most children get immunised against it when they have their MMR vaccine (Measles, Mumps and Rubella). While it isn’t that dangerous for young children, it is extremely dangerous for pregnant women – if exposed to it when in the first trimester, the unborn baby is likely to develop congenital rubella syndrome which can lead to miscarriage stillbirth or severe defects.

    What can you do?

    The condition usually subsides within 7 to 10 days. Phone your GP if you suspect your child has it, and keep them off school for 6 days from the start of their rash. Make sure to avoid any contact with pregnant women for at least a week.

    You can relieve other symptoms by using paracetemol or ibuprofen; they will reduce the fever and dull the aches and pains. Keep your child cool and hydrated if they have a temperature.

  • Impetigo

    What does impetigo look like?

    There are two types of impetigo: bullous impetigo and non-bullous impetigo. Bullous impetigo causes large, painless fluid-filled blisters and non-bullous causes sores that rupture quickly and leave a yellowy brown crust. “It’s characterised by blisters that can burst and crust over and is normally found around the nose and mouth, although it can appear elsewhere,” says Dr Clive Grattan, consultant dermatologist. These crusty patches are small at first, around 0.5cm across, but slowly grow.

    Where?

    It is usually found on the face and hands, as it occurs most frequently on regularly exposed skin. But it can appear anywhere on the body.

    Who gets it?

    It is very contagious and is caused by a bacteria called “staphylococcus aureus” in the UK. If your child has a cut or insect bite, the bacteria can get into their skin. This is called primary impetigo. It can also get into their skin if they have eczema, head lice or scabies, this is known as secondary impetigo. Symptoms appear about 4 to 10 days after the infection enters your skin, so it’s very easy to spread. It is more common in children because their immune system is not fully developed, so they are more vulnerable to infections.

    What can you do?

    It can clear up without treatment within 2 to 3 weeks. But you should visit your GP to make sure your child doesn’t have another, more serious infection. It can also be treated with antibiotics, either prescribed as a cream or tablets. After treatment, the symptoms should clear up within 7 to 10 days. Keep your child off school or nursery during this time, to prevent it from spreading to their friends.

  • Ringworm

    What does ringworm look like?

    This fungal infection has nothing to do with worms. It appears as a round, red patch of skin that can be itchy or scaly. It will spread in circumference as it progresses and it may be blistered or raised or cause a swelling.

    Where?

    Ringworm is usually found on the scalp, but can appear anywhere on the body. When it’s on the scalp, the rash doesn’t tend to be so round – you may notice it under a bald spot on your toddler’s head.

    Who gets it?

    “It is caused by the same fungus that causes athlete’s foot,” says Dr Tim Clayton, a consultant paediatric dermatologist. Anyone who comes into contact with an infected person or animal can catch it. It is caused by a fungus that lives off keratin – a tissue that is found in many parts of your body, including your skin, nails and hair. The fungi can survive for months and can be spread by touching the infected area on someone else’s skin, stroking an animal that is infected and, according to the NHS, “less commonly, you can develop a ringworm infection after lengthy exposure to infected soil.”

    Symptoms are more common in children as adults tend to have developed a defence against the infection, meaning they’re usually carriers but don’t show any symptoms.

    What can you do?

    It can be treated using antifungal creams, tablets and – in the case of scalp ringworm – shampoos. You should go and see your GP as he or she will be able to prescribe specialist treatment for your child, but they may recommend and over-the-counter antifungal cream.

    It usually takes about a month for the ringworm to disappear, but you continue using the creams or tablets until a week after the rash is gone.

  • Slapped cheek syndrome or Fifth disease

    What does slapped cheek disease look like?

    A bright red rash on both cheeks, which is very noticeable in bright sunlight. The NHS says it usually has a “raised, lace-like appearance” and is more noticeable after exercise or if your child is hot. Before the rash occurs, your child may get mild flu-like symptoms such as a high temperature of 38-39°C, a sore throat, an upset stomach, a headache, tiredness and itchy skin. In some cases, these symptoms don’t occur.

    Where?

    The rash starts on your child’s cheeks and, approximately 4 days later, spreads to their chest, stomach and legs a few days later.

    Who gets it?

    It is the fifth most common disease in children. It is spread by droplets of saliva, which can be inhaled when infected children cough or sneeze around your child, or when they touch things that have droplets of saliva on them, and then touch their own mouth or nose.

    What can you do?

    As it is a mild illness, there usually isn’t any need for treatment. But you can give your child paracetemol or ibuprofen to relieve their pain and antihistamines to ease their itchy skin (but speak to your pharmacist for advice on age and dosage). Make sure your child gets plenty of rest and drinks plenty of fluids. As always, speak to your GP if you are unsure.

  • Hand, foot and mouth disease

    What does hand, foot and mouth disease look like?

    The disease causes a non-itchy red rash and sufferers often get mouth ulcers. The rash on the hands and feet can sometimes then develop into painful blisters. It is very common in young children and the rash and blisters can often be accompanied by a loss of appetite, a cough and a moderately high temperature of around 38-39°C.

    Where?

    On the hands and feet, with ulcers appearing in the mouth.

    Who gets it?

    It is caused by a group of viruses known as “enteroviruses”. It is highly contagious until a week after the symptoms begin and is most common in children aged 2-to-10-years-old, but anyone can catch it. It tends to spread fast in nurseries or schools.

    What can you do?

    It gets better on its own without treatment, usually within 7 days. Just make your child feel as comfortable as possible. Use paracetemol, ibuprofen or mouth ulcer gels as pain relief. If they have a moderately high temperature, make sure to give them plenty of fluids and keep them off school or nursery until they feel better – but you don’t have to wait until the last blister disappears before you let them go back. Speak to your GP if you’re unsure whether your child has it.

  • Roseola

    What does roseola look like?

    The roseola rash consists of flat, red spots that are around 2-3mm in width, some have raised areas, but the rash isn’t itchy. It is accompanied by a sudden high temperature of around 40°C, a sore throat, diarrhoea, a cough and a runny nose.

    Where?

    The rash usually starts on your child’s torso and then spreads to their legs and arms.

    Who gets it?

    It’s most common in children aged 6-months-old to 3-years-old. It is a viral infection that is spread via saliva.

    What can you do?

    As it will usually clear up on its own, you can only manage your child’s symptoms by giving them paracetamol or ibuprofen to help with their fever, and make sure they get plenty of fluids – which is very important if they have diarrhoea.

    Keep them home from school or nursery until their symptoms clear.

    As always, it is best to check with your GP when your child has a rash and a fever.

  • Hives

    What do hives look like?

    Also known as Urticaria or nettle rash, hives appear as red and white raised, itchy welts. 

    Where?

    You can get them on any part of the body, often they are limited to one part, but they can spread. Often they disappear from one place and then appear on another.

    Who gets it?

    Hives are caused by your child’s body releasing histamine from the skin’s surface, which, says the NHS, “causes the tissues to swell”. The triggers are often stress, changes in temperature, a reaction to drugs, such as antibiotics, excessive exercise or an allergic reaction to: food, such as peanuts, shellfish, eggs or cheese; environmental factors, such as pollen or dust mites; latex; insect bites or stings.

    What can you do?

    In most cases, the symptoms will be mild and the hives will get better on their own. Antihistamines can help calm hives down, but speak to your pharmacist about the appropriate dose first. If your child’s symptoms get worse or treatment doesn’t work, see your GP.

  • Molluscum contagiosum

    What does Molluscum contagiosum look like?

    “Small, dome-shaped skin coloured spots,” says the NHS. This is usually the only symptom of Molluscum contagiosum (MC). The spots may appear in clusters and they can spread to any part of the body. If they rupture, a thick yellow substance will leak out. This substance is how MC is spread.  It is very important that you don’t squeeze the spots because of this – if you do, it is likely you will spread MC to other parts of their body and your own.

    Where?

    They can appear anywhere, but children are most likely to have them on their hands, arms, face, neck, chest and stomach. “In most cases, otherwise healthy children and adults will have around 20 spots on their body,” says the NHS.

    “In about 1 in 10 cases of MC, patches of eczema develop around the spots,” says the NHS. “It is thought that this happens because some people are very sensitive to the effects of the MC virus.”

    Who gets it?

    Children who are under five are most likely to get it, as are those with a weak immune system. But anyone can get it at any age.

    What can you do?

    It usually clears up on its own, and doesn’t usually leave a scar. Over 6-12 weeks, the spots will crust over and heal. Because it is so contagious, though, as one cluster heals another may just be starting its cycle so a bought can last a long time.

    Treatment isn’t recommended for children unless the spots are affecting them badly. If this is the case, take your child to your GP and they may prescribe creams that are usually used to treat genital warts, acne or psoriasis.  In extreme cases, potassium hydroxide creams may be prescribed.

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